降钙素元结合SOFA评分在小儿脓毒症的诊断及预后的应用研究  

作　　者：时珺[1] 

机构地区：[1]南京医科大学附属南京儿童医院,210011

出　　处：《浙江临床医学》2012年第3期289-291,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨血清降钙素元（PCT）及SOFA评分动态监测对小儿脓毒症的早期诊断并判断预后效果.方法 55例脓毒症患儿入院后24h内进行血常规、痰培养、外周血培养和X线胸片等常规检测;测定肝、肾功能,电解质,动脉血气;体温、白细胞计数、中性粒细胞计数、中性粒细胞比例;测定血清C反应蛋白（CRP）、PCT;进行SOFA评分.并于入院后第4、7天同样采集上述指标,并随访28d.对照组患儿均来自PICU危重患儿.结果 入院后三组患儿相关炎症指标比较可见死亡组及存活组的WBC,中性粒细胞,CRP及PCT均显著高于对照组,但死亡组及存活组两组间差异均无统计学意义.存活组在第4天及第7天较死亡组炎症指标及SOFA评分均明显下降,差异有统计学意义（P〈0.05）.结论 在早期小儿脓毒症中,PCT的大小与病情的轻重相关;在判断预后方面,需结合PCT及SOFA评分才能得到更准确的结果.Objective To investigate the effect of procalcitonin（PCT） score combined with sequential organ failure assessment （SOFA） score on the early diagnosis and prognosis in children with sepsis. Methods Fifty patients with pyemia were enrolled to detect the C reaction protein, PCT, and blood routine test, liver and kidney functions tests were also performed at the first, third and seventh day. Children in PICU with un - infectious disease acted as control. Results The WBC account, percent of neutrophi, CRP and PCT were higher in the death group and the living group of pyemia （ P 〈 0. 05 ）, but there were no significant differences between the death group and the living group. The PCT and SOFA were significantly decreased in the death group compared to the indexes in the living group （ P 〈 0. 05 ）. Conclusions PCT level is related to the severity of sepsis in the early stage, and it is better to combine the PCT and SOFA score to evaluate the prognosis

关 键 词：降钙素元 SOFA评分 小儿脓毒症 早期诊断预后 

分 类 号：R59[医药卫生—内科学]